interpreting CSF results

Question 1

appearance of normal CSF

Answer 1

clear and colourless

Question 2

WBC of normal CSF

Answer 2

0-5cells/µL

No neutrophils present, primarily lymphocytes

Question 3

RBC of normal CSF

Answer 3

0-10/mm³

Question 4

Protein levels of normal CSF

Answer 4

0.15 – 0.45 g/L (or <1% of the serum protein concentration)

Question 5

glucose levels of normal CSF?

Answer 5

2.8 – 4.2 mmol/L (or ≥ 60% plasma glucose concentration)

Question 6

Opening pressure of normal CSF?

Answer 6

10 – 20 cm H2O

Question 7

What route does CSF take in the brain from being produced to being absorbed?

Answer 7

-Ependymal cells create CSF and line the ventricles of the brain and central canal of spinal cord
-CSF is produced mainly by choroid plexus in the lateral third and fourth ventricles
-CSF flows from the lateral ventricle to the third ventricle through the interventricular foramen (AKA foramen of Monro)
-Third and fourth ventricle are connected to eachother by the cerebral aqueduct (AKA aquedujct of Sylvius)
-CSF then flows into the subarachnoid space through the foramina of Lushka (2 of these) and foramina Magendie (1 of these)
-Absorption of CSF into blood stream takes place in superior saggittal sinus through structures called arachnoid villi

Question 8

appearance of CSF in bacterial meningitis?

Answer 8

cloudy and turbid

Question 9

WBC in CSF of bacterial meningitis?

Answer 9

elevated >100 cell/µL (primarily polymorphonuclear leukocytes (>90%))

Question 10

protein in CSF of bacterial meningitis?

Answer 10

elevated (>50 mg/dL)

Question 11

Glucose in CSF of bacterial meningitis?

Answer 11

low (<40% of serum glucose)

bacteria eating up the glucose

Question 12

Opening pressure in bacterial meningitis?

Answer 12

elevated (>25 cm H₂O)

Question 13

Appearance of CSF of viral (aseptic) meningitis?

Answer 13

clear

Question 14

WBC of CSF of viral (aseptic) meningitis?

Answer 14

elevated (50 – 1000 cells/µL, primarily lymphocytes, can be PMN early on)

Question 15

Protein in CSF of viral (aseptic) meningitis?

Answer 15

elevated (>50 mg/dL)

Question 16

Glucose in CSF of viral (aseptic) meningitis?

Answer 16

normal
(>60% serum glucose, however, may be low in HSV infection)

Question 17

Opening pressure in CSF of viral (aseptic) meningitis?

Answer 17

Normal or elevated

Question 18

appearance of CSF in fungal meningitis?

Answer 18

Clear or cloudy

Question 19

WBC in CSF of fungal meningitis?

Answer 19

elevated (10 – 500 cells/µL)

Question 20

protein in CSF of fungal meningitis?

Answer 20

elevated

Question 21

Glucose in CSF of fungal meningitis?

Answer 21

low

Question 22

opening pressure of CSF in fungal meningitis?

Answer 22

elevated